减少重复成像率：将外部图像导入到 PACS。

Reducing the rate of repeat imaging: import of outside images to PACS.

机构信息

Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, M-391, San Francisco, CA 94143-0628, USA.

出版信息

AJR Am J Roentgenol. 2012 Mar;198(3):628-34. doi: 10.2214/ajr.11.6890.

DOI:10.2214/ajr.11.6890

PMID:22358003

Abstract

OBJECTIVE

Repeat imaging at the transfer of care between institutions is a potential source of overutilization. The purpose of this study was to assess whether importing images obtained at one institution to the PACS at another institution reduces the number of repeat imaging examinations performed, sparing patients unnecessary cost and radiation.

MATERIALS AND METHODS

Informed consent was waived for this retrospective study, which included 267 patients who had undergone CT or MRI of the abdomen at our or another institution within 4 months before transarterial chemoembolization. Patients were divided into the following four groups based on the availability of their images from institutions other than ours (outside images): outside imaging performed but images not available; outside images available on CD or film but not imported; outside images imported to PACS; and no outside imaging, that is, all imaging performed at our institution. The rates of repeat imaging in the four groups were compared.

RESULTS

When outside images were not available, 72% (13/18) of patients underwent repeat imaging; when outside images were available but not imported, 52% (14/27); when outside images were imported to PACS, 11% (9/79); and when imaging was performed only at our institution, 13% (18/143). Patients whose outside images were imported were significantly less likely to undergo repeat imaging than were both groups whose outside images were not imported (p < 0.001), and their rate of repeat imaging was similar to that of patients who did not undergo outside imaging (p = 0.79). After adjustment for potential confounders, including age, sex, referring institution, and size and number of lesions, the odds that a patient whose images were imported would undergo repeat imaging were significantly lower than those of a patient whose outside images were not imported (odds ratios, 31 for images not available and 9.0 for images available but not imported; both p < 0.001) and were similar to those of a patient who underwent all imaging at our institution (odds ratio, 0.71; p = 0.51).

CONCLUSION

Importing outside images to PACS reduces the rate of repeat imaging.

摘要

目的

在机构间转院时重复成像可能会导致过度利用。本研究的目的是评估将在一家机构获得的图像导入另一家机构的 PACS 是否会减少重复成像检查的次数，从而使患者避免不必要的费用和辐射。

材料和方法

由于本研究为回顾性研究，故豁免了患者的知情同意。该研究共纳入了 267 例患者，这些患者在接受经动脉化疗栓塞术（TACE）前 4 个月内在我院或其他机构进行了腹部 CT 或 MRI 检查。根据我院以外的其他机构（外院）是否有其图像，将患者分为以下四组：有外院图像但不可用；有外院图像的 CD 或胶片但未导入；外院图像已导入 PACS；以及无外院图像，即所有图像均在我院进行。比较了四组患者的重复成像率。

结果

当外院图像不可用时，72%（13/18）的患者进行了重复成像；当外院图像可用但未导入时，52%（14/27）的患者进行了重复成像；当外院图像已导入 PACS 时，11%（9/79）的患者进行了重复成像；当仅在我院进行成像时，13%（18/143）的患者进行了重复成像。与外院图像未导入的两组患者相比，导入外院图像的患者进行重复成像的可能性显著降低（p<0.001），且其重复成像率与未进行外院成像的患者相似（p=0.79）。在调整潜在混杂因素（包括年龄、性别、转诊机构、肿瘤大小和数量）后，与外院图像未导入的患者相比，导入外院图像的患者进行重复成像的可能性显著降低（优势比，图像不可用时为 31，图像可用但未导入时为 9.0；均 p<0.001），且与在我院进行所有成像的患者相似（优势比，0.71；p=0.51）。